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Tuesday, October 10, 2017

What ADHD Looks Like

Kaden has ADHD.

Phew, hard part over. I said it. I wrote it.

He was diagnosed this past July with a mild to moderate form of ADHD. & for us, it was a really long and bumpy road, one that was about 18 months long. One that had Justin and I doubting our parenting ability. One that had us second guessing if we were doing all we could for Kaden or if we were putting too much pressure on his shoulders, after all, he was only six when this journey started. One that took us to see multiple doctors and fill out multiple evaluations. & if I am being completely honest, one that had me fearing how not only Kaden would be judged but also how we would be judged. Would kids not want to play with him, parents not want to include him in birthday parties. Sadly, my list of worries were pretty long---all valid. Yes, every parent worries about their kid making friends but now, that worry was exemplified ten thousand times. So after we began the journey we didn't stop until we had answers and that took awhile to get--here's why.

We've known for awhile that Kaden has more energy than most kids his age but some kids just have more energy. We have also known that awhile that Kaden can easily get frustrated. Not to mention he can be easily distracted. I mean, we've lovingly referred to him as light switch-he's either on or off, there was never really an in between. The kid loves harder than anyone that I know but he can throw a fit with the best of them too. And as parents we were very aware of all of this, the last thing we wanted to be was naive because that would help no one. We spoke about this with our pediatrician early on & every so often we would check in and evaluate. During the second half of kindergarten our pediatrician suggested that maybe we just fill out a Vanderbuilt assessment and see where he falls. So we did. Both his teacher & then Justin and I (taken separately and at different times) did not show that he was clinically significant to be diagnosed. For those that are not familiar with the diagnoses, you must be clinically significant in two settings, for us that is at school and at home. So we implemented a few behavior modifications at home only because there was no concern with his behavior at school with his teacher. He followed these rules without issue and we really didn't see any decline in his behavior.

Fast forward to October 2016--I took a mental health day. I was wiped. As I was resting at home I got a call from the school's principal. Kaden had punched a kiddo on the school bus. He would be spending the day in in-school suspension with the principal. The principal wasn't all too concerned about the instance and felt that it wouldn't be repeated because this wasn't typical behavior they saw out of Kaden. & I agreed, we hadn't seen aggression before. He explained that the kid on the bus was singing and Kaden had politely asked him to stop a handful of times and he didn't. As they were walking off the bus to enter the school, he asked one more time and when the kiddo wouldn't stop, he punched him the stomach. Kaden told the truth. He didn't lie about it which everyone was proud to see but he still had to pay the consequences. This event kicked off a number of doctors visit, some with Kaden, some without. We knew this was another red flag and it was time to dig a little deeper. So we did.

We met with his pediatrician again. We filled out the Vanderbuilt assessment again. We met with a child psychologist. Followed by the Conner's assessment which is similar to the Vanderbuilt. We bought books and read what was given to us to read. This time around the results were a little different, his first grade teacher had him rated clinically significant at school, Justin and I did not. So now we were in limbo. Kaden clearly had similar symptoms to a child with ADHD but he couldn't be formally diagnosed since it wasn't present in two settings. Furthermore, his grades were good. So with the teacher's help we implemented some behavior modifications at school.

For awhile, this seemed to work pretty well but then we hit a pretty rough patch at school. His teacher and I had, what I thought was, pretty good communication but then I think the communication got to be too much. Probably for both of us. I was learning of his behavior before I could event get home to let him tell me about his day. I started developing anxiety and getting through work at times was just draining because I knew 3 o'clock was coming and if an email showed up, it wasn't a good day. Some of the emails were justified, majority, sadly weren't or I felt was "normal boy behavior". And I don't blame anyone for this except myself, I engaged very early on and wanted the teacher to know we not only cared & had her back but that we were involved too. However, at some point, you've gotta have your kid's back. After all, if we can't, who will. So I called a meeting between the principal and his teacher. We had 5 weeks left of school and as much as we would have loved to just push forward and get through those weeks, that wasn't what was best for Kaden, his teacher or us. The meeting in and of itself was pretty okay but we don't believe anything got accomplished, which was sad but we got it. Kaden didn't fit the mold nor would he.

What it did do, was show us that Kaden has more advocates than just his dad and I. We all wanted to see him excel & felt that it was very important to ensure that we set him up for success heading into second grade. This meant, finding the best fit atmosphere & teacher for his needs. Structure with flexibility to be himself and let all his positive qualities shine--because he has SOOO many of them.

& we couldn't forget about Logan. The boys are back to back in school. Logan would be entering first grade and it was important for him to not have to walk in Kaden's shadow. It was important for him to be able to create his own identity--good, bad or indifferent. & honestly, Kaden didn't need to be compared to Logan either so it was decided that the boys would not have the same teacher from that point forward--which I am sure we will win out on at times and lose out on at times.

When school came to an end we found out that his reading grade would be dropping. At winter break he was already at a 2nd grade reading level but now, somehow, his reading had regressed even beyond where he should have been in December and now would be entering 2nd grade below reading level. We were beyond pissed with this new revelation. One, it was really the first time we were hearing about him having any issues with reading comprehension. Two, we never once heard from his actual reading teacher -- they switch teachers for reading groups. Three, he was in the highest reading group. Four, he wasn't tested by his reading teacher when it came to his reading grade. Five, FOUR days before school was ending we were learning about this & when we questioned why, they said they didn't have to test him in 3Q because he was above where he was supposed to be--well, the system failed. We should be better than the system. We should want more for our kids.

To note--We brought up his reading grade when we met with the principal and his teacher because it didn't show any progress and asked if there was something we should be doing at home to help & we were told that he wasn't tested and thus it showed no growth. I commented how it would be nice to have a disclaimer for those students who weren't tested as we were worried he wasn't progressing but at the time we were assured that wasn't the case.

Also to note--I'm sure I have quite the reputation at school as being a difficult mother and frankly, I'm okay with that. I mean, we are talking about a 7 year old boy, our boy, who isn't able to reach his potential for one reason or another. Some parents on this journey would have already been directed to medication but we weren't. The evaluations weren't supporting that option but anytime you are looking at medication as an option, it takes the severity of the situation to a whole other level. We don't take talking about medicating our child lightly and was hoping for a little more understanding than I felt we got.

However mad we were at the situation, it gave us some more color into Kaden's world. It seemed that his behavior was now affecting his school work. It also confirmed that we couldn't stop fighting for him. We couldn't stop looking for answers. It was our job to set him up with all the tools needed for him to succeed. & that was what we were going to do. As school was winding down we reached back out to our pediatrician to catch up. We mentioned trying a very low dosage of ADHD medication over the summer to see if it would help him. I mean, we had already implemented behavior modifications--probably too many of them to be honest. It was time to see if we could look at using medication in conjunction with behavior modifications. She suggested we see the ADHD Clinic at Children's Mercy before doing so since Kaden still wasn't diagnosed. We agreed.

In July we sat down with the ADHD Clinic. Kaden was with us. Our meeting lasted two hours. We met with a team of doctors--a child's psychologist and an pediatric MD. Prior to our appointment we reached out to his teacher and asked if she would fill out one last evaluation for us. She thankfully agreed--and for the record, we never doubted for a second that she didn't want what was best for Kaden too. We talked a lot during that appointment--both Kaden and I. I cried during the appointment. Again, this is our child. Our first born and I didn't want him thinking he wasn't already perfect in every way. It's a hard concept for a kiddo his age to comprehend, one, frankly, he shouldn't have to. After about an hour and a half the doctors left to discuss among themselves for a few minutes & came back. With the results.

& I cried. Again. But not because our child had ADHD, but BECAUSE our child had ADHD. It wasn't his fault he was acting impulsively. It wasn't his fault he was fidgeting. It wasn't his fault he had more energy than most kids. His brain just isn't wired like the average kiddo's brain. Finally we had answers and more importantly a plan to help set Kaden up for success. Although the evaluations still showed Kaden clinically significant at school & not at home, they felt confident diagnosing him with a mild to moderate form of ADHD. They felt that if not for the behavior modifications that we had in place at home paired with being able to sit down and talk to us in depth with what we were experiencing day to day that it made sense to look at the next step. Medication. We not only left the office that day with a prescription--one that has to be mailed to me monthly since its a controlled substance--but we also left that office with HOPE. I could instantly feel the weight being lifted off my shoulders and honestly, Kaden's too.

The one area that I was struggling with was how to explain it to Kaden. We didn't want him to think that he wasn't okay just the way that he was or that he had to take this medication to be a "better" kid. So we asked for help with that explanation and we were given a really great response. We were told to be honest & to explain it like having a brain that runs like a really fast car but when it comes to stopping that fast car we only have bicycle breaks. This will help him slow down so that he can pay greater attention to the smaller details. He got it. That was all he needed.

We are now three months in with medication, a new school year and a new teacher. Justin and I have noticed a huge improvement in overall behavior at home because he is slowing down and thinking about his choices before acting. We have noticed the attention and focus that he has been giving to his homework in the classroom. It's no longer a challenge to get him to do his homework, in fact, he likes knocking it out right away rather than waiting. He talks more openly about his day and what they are learning in school. He and his brother seem to get along better--most of the time, they are still brothers. & it's not just us noticing the changes. We had a follow up appointment with the ADHD clinic & the psychologist said that his teacher's evaluation showed NO signs of ADHD in the classroom. Let me repeat that again, NO signs. We even got an email from the teacher after she did his beginning of the year reading assessment...

Subject: Checking In :)

Hi Kayla!

I just wanted to let you know how much I am enjoying Kaden!

I was thinking about your email before school started, and I know that making the choice to put him on medication was a hard one. I just wanted to tell you that your being brave is helping him!

He is working hard, and I can tell he is anxious to learn and to show what he's learning.

His end of the year reading level was below grade level, but I did his assessment today and he is right on grade level. I'm sure that having his brain slow down has made a big difference. I can appreciate the difference it can make and the courage that it takes.

Thank you for sharing your sweet boy with me.

I mean talk about instant tears. For the first time in a long time, I felt as though we were at a really good place. For Kaden. For our family.

I've learned so much over the last 18 months, hell two years now. I learned that ADHD is not something to be embarrassed about or to be taboo about. Quite the opposite. Again, this wasn't Kaden CHOOSING to make poor choices, his brain literally does not function like a normal brain would. It's a real disorder. A real problem and for us, a real obstacle--and thus we continued to push until we got REAL answers which led us to REAL solutions. Today, we see Kaden succeeding. Honestly, he is flourishing & enjoying more of what life has to offer along the way. His sweet demeanor and kind heart shines through much more often.

At times, I wonder how things would have gone had we jumped to medication earlier. Would that have changed how the second half of his first grade year went? Probably. However, I'd always wonder if medication was really meant for him or if it was just the easiest thing to do. Instead, we took the long, bumpy path and I wouldn't change that for the world. I know we exhausted all options before we looked at medication and for that I am thankful. I have no concerns giving Kaden the medication at this stage of our journey. It was that missing tool he needed to set him up for success. Have there been side effects? Yes. A few tics (which he likely had before but they were super subtle) have been heightened but thankfully they don't seem to get too much in the way. & he's dealing with them like a champ. He's lost a little bit of weight but that just means we need to pump him full of more protein--again, to be expected and nothing any his doctors are worried about. Do we still have our battles--yes. Do we still have our challenges--yes, specifically dealing with disappointment and setting realistic expectations. It's just now, we know we have a little added help when it comes to helping him through this normal childhood obstacles.

So this is what ADHD looks like to us. It comes with many faces, this is ours.